tbuckley/cabot-search huggingface dataset:
The influence of surgery on the natural history of angiographically documented left ventricular aneurysm: the Coronary Artery Surgery Study.
Authors: D P Faxon, W O Myers, C H McCabe, K B Davis, H V Schaff, J W Wilson, T J Ryan
Journal: Circulation (1986)

Coronary artery bypass surgery with or without aneurysmectomy has been used to treat patients with angiographically defined left ventricular aneurysm. To evaluate whether surgery benefits such patients, we analyzed the data from 1131 patients who were enrolled in the registry of the Coronary Artery Surgery Study. Four hundred sixty-seven patients underwent bypass surgery, of which 238 also had left ventricular resection, and 30 had resection alone. The overall operative mortality was 7.9%; the operative mortality was 7% for bypass alone compared with 9% for bypass surgery plus left ventricular resection (NS). Long-term survival by life-table analysis was similar for both medically and surgically treated patients (69% vs 67%, respectively). Cox survival analysis identified congestive heart failure score, duration of chest pain, extent of coronary disease, left ventricular end-diastolic pressure, age, and surgical therapy as important predictors of outcome. Patient subsets that showed improved survival with surgical therapy after adjustment for inequities in baseline characteristics were patients with three-vessel disease and those patients in moderate- and high-risk subgroups. Surgical therapy significantly reduced symptoms of angina and use of cardiac medications but the incidence of recurrent infarction was similar for both therapies.
Treatment of Paget Disease of Bone (Osteitis Deformans)
Authors: M. Rashid A. Khairi
Journal: JAMA (1974)

A double-blind crossover study was performed in which 50 symptomatic patients with Paget disease were treated with sodium etidronate (EHDP) doses of 1, 2.5, 5, 10, or 20 mg/kg or were given placebo. After six months, the patients were reassigned to treatment with placebo or sodium etidronate, 5,10, or 20 mg/kg. Sodium etidronate in dosages of 5,10, or 20 mg/kg/day resulted in significant improvement in levels of serum alkaline phosphatase and urinary hydroxyproline, as well as clinical symptoms and bone scans. Bone scans and urinary determinations showed statistically greater improvement with sodium etidronate 20 mg/kg, in comparison to patients who received sodium etidronate 5 mg/kg for 12 months. After withdrawal of effective therapy, five of nine patients continued to have remission of their symptoms with placebo for an additional six months. (<i>JAMA</i>230:562-567, 1974)
Acquired Immunodeficiency Syndrome in Low-Incidence Areas
Authors: David W. Fleming
Journal: JAMA (1987)

Serum specimens from the cohort of persons who attended sexually transmitted disease clinics in New Mexico during a two-month period were tested for human immunodeficiency virus (HIV) antibody. Twenty-seven (2.0%) of 1374 serum specimens had repeatedly low-positive reactions by enzyme-linked immunosorbent assay testing, and 22 (1.6%) had repeatedly high-positive reactions. All sera (sufficient for testing by Western blot) with low-positive reactions gave negative results, and all sera (sufficient for testing by Western blot) with high-positive reactions gave positive results. All persons whose serum had high-positive reactions were male. Most (86%) had been seen at the only urban sexually transmitted disease clinic in New Mexico, and most (72%) were openly gay or bisexual. Of all gay and bisexual men evaluated, 14% (16/112) had high-positive reactions. Rapid plasma reagin positivity was significantly associated with HIV enzyme-linked immunosorbent assay low (false) positivity. The relatively high rate of HIV seropositivity among gay men with other sexually transmitted diseases indicates that transmission of acquired immunodeficiency syndrome is continuing in this low-incidence area and documents the need for testing and counseling programs in sexually transmitted disease clinics. (<i>JAMA</i>1987;258:785-787)
Oropharyngeal Decontamination Decreases Incidence of Ventilator-Associated Pneumonia
Authors: Jérôme Pugin, Raymond Auckenthaler, Daniel P. Lew, Peter M. Suter
Journal: JAMA (1991)

Secondary pneumonia in patients requiring mechanical ventilation has a high morbidity and mortality. Diagnosis is difficult and treatment failure common; therefore, preventive measures are important. In a double-blind, placebo-controlled trial, we evaluated selective decontamination of the oropharynx with polymyxin B sulfate, neomycin sulfate, and vancomycin hydrochloride (PNV) in 52 patients requiring mechanical ventilation during a 3- to 34-day period (mean, 10 days). Either PNV or placebo was administered six times daily in the oropharynx. During the first 12 days of intubation, tracheobronchial colonization by gramnegative bacteria and<i>Staphylococcus aureus</i>, as well as pneumonia, occurred less frequently in the PNV than in the placebo group (16% vs 78%;<i>P</i>&lt;.0001). Hospital mortality was not different, but systemic antibiotics were prescribed less often in the PNV group and no resistant microorganism emerged. In these critically ill patients, topical oropharyngeal antibiotic application lowered the rate of ventilator-associated pneumonia by a factor of 5, probably by interrupting the stomach-to-trachea route of infection, and decreased the requirement for intravenous antibiotics. (<i>JAMA</i>. 1991;265:2704-2710)
HEMOLYTIC ASSAY OF THE NINTH COMPLEMENT COMPONENT: ELEVATION AND DEPLETION IN RHEUMATIC DISEASES
Authors: Shaun Ruddy, Lloyd K. Everson, Peter H. Schur, K. Frank Austen
Journal: The Journal of Experimental Medicine (1971)

An effective molecule titration for the ninth component of complement in the biologic fluids of man was developed using EAC1-8 cells produced by treating EAC14 cells with a chromatographic fraction of human serum containing C2, C3, C5, C6, C7, and C8. Kinetic studies of the interaction of EAC1-8 with C9 indicated that this component was depleted from the fluid phase, and that the lytic reaction proceeded most rapidly at ionic strength 0.145, and at a temperature of 37°C. The mean value for C9 in normal serum was 52,000 ±12,000 units/ml. The mean serum C9 for patients with DJD, rheumatoid arthritis, or SLE without active renal disease was approximately twice the mean for normal individuals. Patients with SLE and active renal disease had a mean C9 value which fell within the normal range, but was significantly lower than in patients with SLE who did not have active renal disease. Two instances of absolutely subnormal C9 levels were observed in patients during attacks of florid SLE, including nephritis. Since the usual change in serum C9 in rheumatic diseases is a marked elevation, the occurrence of a subnormal value reflects circumstances in which depletion due to activation of the sequence exceeds the increases associated with the inflammatory response.
Hereditary Hyperferritinemia-Cataract Syndrome Caused by a 29-Base Pair Deletion in the Iron Responsive Element of Ferritin L-Subunit Gene
Authors: Domenico Girelli, Roberto Corrocher, Luigi Bisceglia, Oliviero Olivieri, Leopoldo Zelante, Giacomo Panozzo, Paolo Gasparini
Journal: Blood (1997)
An Extended Study of Indomethacin
Authors: Norman O. Rothermich
Journal: JAMA (1966)

The effects of indomethacin were studied in the human on long-term therapy in 234 patient-trials and on largedose, acute toxicity trials in six patients. Side effects were limited to the central nervous system (CNS), with symptoms of headache, vertigo, light-headedness, and disturbed sensorium, and to the gastrointestinal system, with symptoms of epigastric pain, cramping, and peptic ulceration. The CNS side effects were quite frequent, reaching a total incidence of 47.1% and were severe enough in 20% to require discontinuance of the drug. These side effects are of a transient nature without residuals or sequelae and disappear promptly on cessation of the drug. The gastrointestinal symptoms were less frequent, and in only 12.5% were they severe enough to warrant cessation of the drug. The high incidence of side effects was influenced by the exceptionally high doses used in this experimental study; the incidence in clinical therapy would be much lower. No other complications or side effects could be detected.
The Urgent Need to Refocus Cardiovascular Disease Prevention Efforts on Young Adults
Authors: Norrina Allen, John T. Wilkins
Journal: JAMA (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Safe engineering of cancer-associated fibroblasts enhances checkpoint blockade immunotherapy
Authors: Shizhen Geng, Tingting Xiang, Yunya Zhang, Pengke Guo, Hongling Zhang, Zhenzhong Zhang, Mengchao Gu, Kaixiang Zhang, Haiwei Song, Jinjin Shi, Junjie Liu
Journal: Journal of Controlled Release (2023)
Comparison of 3- to 6-Month Versus 12-Month Dual Antiplatelet Therapy After Coronary Intervention Using the Contemporary Drug-Eluting Stents With Ultrathin Struts: The HOST-IDEA Randomized Clinical Trial
Authors: Jung-Kyu Han, Doyeon Hwang, Seokhun Yang, Sang-Hyeon Park, Jeehoon Kang, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Seung-Ho Hur, Weon Kim, Seok Yeon Kim, Sang-Hyun Park, Seung Hwan Han, Sang-Hyun Kim, Sanghoon Shin, Yong Hoon Kim, Kyungil Park, Namho Lee, Seung Jin Lee, Jin Won Kim, Hyo-Soo Kim
Journal: Circulation (2023)

Limited data are available on short-term dual antiplatelet therapy (DAPT) after percutaneous coronary intervention using third-generation drug-eluting stents with ultrathin struts and advanced polymer technology. We investigated whether 3- to 6-month DAPT was noninferior to 12-month DAPT after implantation of drug-eluting stents with ultrathin struts and advanced polymer technology.We performed an open-label, randomized trial at 37 centers in South Korea. We enrolled patients undergoing percutaneous coronary intervention using the Orsiro biodegradable-polymer sirolimus-eluting stents or the Coroflex ISAR polymer-free sirolimus-eluting stents. Patients with ST-segment-elevation myocardial infarction were excluded. Patients were randomly assigned to receive either 3- to 6-month or 12-month DAPT after percutaneous coronary intervention. The choice of antiplatelet medications was at the physician's discretion. The primary outcome was a net adverse clinical event, a composite of cardiac death, target vessel myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, or major bleeding, defined as Bleeding Academic Research Consortium type 3 or 5 at 12 months. The major secondary outcomes were target lesion failure, a composite of cardiac death, target vessel myocardial infarction, clinically driven target lesion revascularization, and major bleeding.A total of 2013 patients (mean age, 65.7±10.5 years; 1487 males [73.9%]; 1110 [55.1%] presented with acute coronary syndrome) were randomly assigned to 3- to 6-month DAPT (n=1002) or 12-month DAPT (n=1011). The primary outcome occurred in 37 (3.7%) patients in the 3- to 6-month DAPT group and 41 (4.1%) in the 12-month DAPT group. The noninferiority of the 3- to 6-month DAPT group to the 12-month DAPT group was met (absolute risk difference, -0.4% [1-sided 95% CI, -∞% to 1.1%]; P<0.001 for noninferiority). There were no significant differences in target lesion failure (hazard ratio, 0.98 [95% CI, 0.56-1.71], P=0.94) or major bleeding (hazard ratio, 0.82 [95% CI, 0.41-1.61], P=0.56) between the 2 groups. Across various subgroups, the treatment effect of 3- to 6-month DAPT was consistent for net adverse clinical event.Among patients undergoing percutaneous coronary intervention using third-generation drug-eluting stents, 3- to 6-month DAPT was noninferior to 12-month DAPT for net adverse clinical event. Further research is needed to generalize this finding to other populations and to determine the ideal regimen for 3- to 6-month DAPT.URL: https://www.gov; Unique identifier: NCT02601157.
Cardiovascular Risk Factor Prevalence, Treatment, and Control in US Adults Aged 20 to 44 Years, 2009 to March 2020
Authors: Rahul Aggarwal, Robert W. Yeh, Karen E. Joynt Maddox, Rishi K. Wadhera
Journal: JAMA (2023)

Declines in cardiovascular mortality have stagnated in the US over the past decade, in part related to worsening risk factor control in older adults. Little is known about how the prevalence, treatment, and control of cardiovascular risk factors have changed among young adults aged 20 to 44 years.
Polytonic Drug Release via Multi‐Hierarchical Microstructures Enabled by Nano‐Metamaterials
Authors: Qi Lou, Feng Feng, Junfeng Hui, Peisen Zhang, Shijie Qin, Xiaoping Ouyang, Dazhuan Wu, Xiuyu Wang
Journal: Advanced Healthcare Materials (2023)

″Nano-metamaterials″, rationally designed novel class metamaterials with multilevel microarchitectures and both characteristic sizes and whole sizes at the nanoscale, are introduced into the area of drug delivery system (DDS), and the relationship between release profile and treatment efficacy at the single-cell level is revealed for the first time. Fe3+ -core-shell-corona nano-metamaterials (Fe3+ -CSCs) are synthesized using a dual-kinetic control strategy. The hierarchical structure of Fe3+ -CSCs, with a homogeneous interior core, an onion-like shell, and a hierarchically porous corona. A novel polytonic drug release profile occurred, which consists of three sequential stages: burst release, metronomic release, and sustained release. The Fe3+ -CSCs results in overwhelming accumulation of lipid reactive oxygen species (ROS), cytoplasm ROS, and mitochondrial ROS in tumor cells and induces unregulated cell death. This cell death modality causes cell membranes to form blebs, seriously corrupting cell membranes to significantly overcome the drug-resistance issues. It is first demonstrated that nano-metamaterials of well-defined microstructures can modulate drug release profile at the single cell level, which in turn alters the downstream biochemical reactions and subsequent cell death modalities. This concept has significant implications in the drug delivery area and can serve to assist in designing potential intelligent nanostructures for novel molecular-based diagnostics and therapeutics.
Experimental Study on Repairing Peripheral Nerve Defects with Novel Bionic Tissue Engineering
Authors: Tong Qi, Xu Zhang, Xiaosong Gu, Shusen Cui
Journal: Advanced Healthcare Materials (2023)

Peripheral nerve defects are a worldwide problem, and autologous nerve transplantation is currently the gold-standard treatment for them. Tissue-engineered nerve (TEN) grafts are widely considered promising methods for the same, and have attracted much attention. To improve repair, the incorporation of bionics into TEN grafts has become a focus of research. In this study, a novel bionic TEN graft with a biomimetic structure and composition is designed. For this purpose, a chitin helical scaffold is fabricated by means of mold casting and acetylation using chitosan as the raw material, following which a fibrous membrane is electrospun on the outer layer of the chitin scaffold. The lumen of the structure is filled with human bone mesenchymal stem cell-derived extracellular matrix and fibers to provide nutrition and topographic guidance, respectively. The prepared TEN graft is then transplanted to bridge 10 mm sciatic nerve defects in rats. Morphological and functional examination shows that the repair effects of the TEN grafts and autografts are similar. The bionic TEN graft described in this study shows great potential for application and offers a new way to repair clinical peripheral nerve defects.
CAR T cell therapy for T cell leukemia and lymphoma: latest updates from 2022 ASH Annual Meeting
Authors: Qiusha Huang, Xiao-hui Zhang, Delong Liu
Journal: Journal of Hematology & Oncology (2023)

Abstract Due to the concern of fratricide, clinical development of CAR T cells for the therapy of T cell malignancies lags behind that for B cell malignancies. Attempts are being made to revise T cell biomarkers so that the re-engineered CAR T cells can target T cell malignancies. CD3 and CD7 are the two pan-T cell surface biomarkers that have been either knocked out or knocked down through genome base- editing technology or by protein expression blockers so that the re-engineered T cells can target T cells without fratricide. We summarized several latest reports on the CAR T cells for the therapy of T cell leukemia /lymphoma from the 2022 ASH Annual Meeting, with latest updates on clinical trials of TvT CAR7, RD-13-01, and CD7 CART.
Postsurgical wound management and prevention of triple-negative breast cancer recurrence with a pryoptosis-inducing, photopolymerizable hydrogel
Authors: Dandan Mi, Jiaojiao Li, Rujing Wang, Yuke Li, Lan Zou, Chen Sun, Shenao Yan, Huan Yang, Mengnan Zhao, Sanjun Shi
Journal: Journal of Controlled Release (2023)
Self-Management Support Using Advertising Principles for Older Adults With Low Income at High Cardiovascular Risk: A Randomized Controlled Trial
Authors: David J.T. Campbell, Marcello Tonelli, Brenda R. Hemmelgarn, Peter Faris, Jianguo Zhang, Flora Au, Ross T. Tsuyuki, Chad Mitchell, Raj Pannu, Tavis Campbell, Noah Ivers, Jane Fletcher, Derek V. Exner, Braden J. Manns
Journal: Circulation (2023)

Background: Self-management education and support (SMES) interventions have modest effects on intermediate outcomes for those at risk of cardiovascular disease, but few studies have measured or demonstrated an effect on clinical end points. Advertising for commercial products is known to influence behavior, but advertising principles are not typically incorporated into SMES design. Methods: This randomized trial studied the effect of a novel tailored SMES program designed by an advertising firm among a population of older adults with low income at high cardiovascular risk in Alberta, Canada. The intervention included health promotion messaging from a fictitious “peer” and facilitated relay of clinical information to patients’ primary care provider and pharmacist. The primary outcome was the composite of death, myocardial infarction, stroke, coronary revascularization, and hospitalizations for cardiovascular-related ambulatory care–sensitive conditions. Rates of the primary outcome and its components were compared using negative binomial regression. Secondary outcomes included quality of life (EQ-5D [EuroQoL 5-dimension] index score), medication adherence, and overall health care costs. Results: We randomized 4761 individuals, with a mean age of 74.4 years, of whom 46.8% were female. There was no evidence of statistical interaction ( P =0.99) or of a synergistic effect between the 2 interventions in the factorial trial with respect to the primary outcome, which allowed us to evaluate the effect of each intervention separately. Over a median follow-up time of 36 months, the rate of the primary outcome was lower in the group that received SMES compared with the control group (incidence rate ratio, 0.78 [95% CI, 0.61 to 1.00]; P =0.047). No significant between-group changes in quality of life over time were observed (mean difference, 0.0001 [95% CI, −0.018 to 0.018]; P =0.99). The proportion of participants who were adherent to medications was not different between the 2 groups ( P =0.199 for statins and P =0.754 for angiotensin-converting enzyme inhibitors/angiotensin receptor blockers). Overall adjusted health care costs did not differ between those receiving SMES and the control group ($2015 [95% CI, −$1953 to $5985]; P =0.320). Conclusions: For older adults with low income, a tailored SMES program using advertising principles reduced the rate of clinical outcomes compared with usual care. The mechanisms of improvement are unclear and further studies are required. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02579655.
Eliminating Medication Copayments for Low-Income Older Adults at High Cardiovascular Risk: A Randomized Controlled Trial
Authors: David J.T. Campbell, Chad Mitchell, Brenda R. Hemmelgarn, Marcello Tonelli, Peter Faris, Jianguo Zhang, Ross T. Tsuyuki, Jane Fletcher, Flora Au, Scott Klarenbach, Derek V. Exner, Braden J. Manns
Journal: Circulation (2023)

One in eight people with heart disease has poor medication adherence that, in part, is related to copayment costs. This study tested whether eliminating copayments for high-value medications among low-income older adults at high cardiovascular risk would improve clinical outcomes.This randomized 2×2 factorial trial studied 2 distinct interventions in Alberta, Canada: eliminating copayments for high-value preventive medications and a self-management education and support program (reported separately). The findings for the first intervention, which waived the usual 30% copayment on 15 medication classes commonly used to reduce cardiovascular events, compared with usual copayment, is reported here. The primary outcome was the composite of death, myocardial infarction, stroke, coronary revascularization, and cardiovascular-related hospitalizations over a 3-year follow-up. Rates of the primary outcome and its components were compared using negative binomial regression. Secondary outcomes included quality of life (Euroqol 5-dimension index score), medication adherence, and overall health care costs.A total of 4761 individuals were randomized and followed for a median of 36 months. There was no evidence of statistical interaction (P=0.99) or of a synergistic effect between the 2 interventions in the factorial trial with respect to the primary outcome, which allowed us to evaluate the effect of each intervention separately. The rate of the primary outcome was not reduced by copayment elimination, (521 versus 533 events, incidence rate ratio 0.84 [95% CI, 0.66-1.07], P=0.162). The incidence rate ratio for nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death (0.97 [95% CI, 0.67-1.39]), death (0.94 [95% CI, 0.80 to 1.11]), and cardiovascular-related hospitalizations (0.78 [95% CI, 0.57 to 1.06]) did not differ between groups. No significant between-group changes in quality of life over time were observed (mean difference, 0.012 [95% CI, -0.006 to 0.030], P=0.19). The proportion of participants who were adherent to statins was 0.72 versus 0.69 for the copayment elimination versus usual copayment groups, respectively (mean difference, 0.03 [95% CI, 0.006-0.06], P=0.016). Overall adjusted health care costs did not differ ($3575 [95% CI, -605 to 7168], P=0.098).In low-income adults at high cardiovascular risk, eliminating copayments (average, $35/mo) did not improve clinical outcomes or reduce health care costs, despite a modest improvement in adherence to medications.URL: https://www.gov; Unique identifier: NCT02579655.